IVF doctors ordered to reduce multiple births

Last updated at 11:33 18 October 2006

Experts are expected to recommend today that fertility doctors try to prevent twin and triplet pregnancies. Doctors will be advised that multiple births are so risky for the mother and babies that in most cases they should only place one embryo in the womb.

The move will alarm some patients, who feel it will limit their chances of having a family through IVF treatment. At present, clinicians are allowed to put two, and occasionally three, embryos in a woman's womb to give couples the best chance of success.

But the rates of twin and triplet pregnancies has risen and experts are concerned about the health risks it poses to the woman and babies and the financial burden it places on the NHS to care for them.

Twins are four times more likely to have problems after birth and cost the NHS £3,000 more than a single birth because of the likelihood of them needing intensive care.

Triplets are 10 times more likely to suffer complications and cost £21,000 more than a single birth. The rate of cerebral palsy among twins is five times that for single babies. For triplets the rate is 18 times greater.

Today, the Expert Group on Multiple Births After IVF will recommend what action the Human Fertilisation and Embryology Authority should take. Figures for 2003 show that almost three quarters of all in-vitro fertilisation cycles involved placing two embryos in the womb and almost a quarter of all live births were of twins.

Yet research has shown there is no significant difference in pregnancy rates irrespective of whether one or two embryos are used. The expert group will say that couples should be given more NHS treatment if the move to single embryo transfers goes ahead, rather than the one free cycle they are entitled to at present.

They will argue that the move would save money in the long run because of the reduced need for intensive care for twins, who are often born premature.

In June, Dame Suzi Leather, then chairwoman of the authority, said fertility clinics were still implanting too many embryos and couples needed to think about the risks of multiple births.

Dame Suzi said: "They need to question whether it is really sensible to want a baby at any cost... we have to think about the success in IVF being a healthy baby, ideally one at a time."

Britain has one of the highest rates in Europe of multiple births following fertility treatment. Other countries have brought their rates down through agreements to only place one embryo in the womb. Single embryo transfer is used in 60 per cent of women under 36 in Finland, in all women under 35 in Belgium and in all but those with exceptional circumstancesin Sweden. Patient groups say education must go hand in hand with any changes in Britain to avoid upsetting couples.

Claire Brown of Infertility Network UK said: "Patients have huge concerns about anything that affects the success rates of the treatment. We need to make them aware of the physical risk to both the mother and the potential children and we need more funding in place to give couples a fair chance.

"Fertility treatment involves a huge physical and emotional investment and when couples see lovely twins walking around and everything is fine they do not see a problem. The majority of twins are fine but a significant number are not."

She said many couples already find it hard to get their one free cycle of treatment on the NHS so want to ensure the best chance.